Table 1:
Baseline characteristics of patients referred for liver transplantation by time to evaluation
| Total | Early evaluation | Late evaluation | P Value | |
|---|---|---|---|---|
|
| ||||
| Total | 1118 | 832 | 286 | |
|
| ||||
| Referral Year, N (%) | <0.0001 | |||
| 07/2013–12/2013 | 124 | 37(29.8%) | 87(70.2%) | |
| 2014 | 233 | 154(66.1%) | 79(33.9%) | |
| 2015 | 226 | 173(76.5%) | 53(23.5%) | |
| 2016 | 280 | 237(84.6%) | 43(15.4%) | |
| 2017 | 212 | 191(90.1%) | 21(9.9%) | |
| 01/2018–03/2018 | 43 | 40(93.0%) | 3(7.0%) | |
|
| ||||
| Center, N (%) | <0.0001 | |||
| Station 1 | 170 | 131(77.1%) | 39(22.9%) | |
| Station 2 | 113 | 89(78.8%) | 24(21.2%) | |
| Station 3 | 226 | 187(82.7%) | 39(17.3%) | |
| Station 4 | 292 | 197(67.5%) | 95(32.5%) | |
| Station 5 | 152 | 66(43.4%) | 86(56.6%) | |
| Station 6 | 165 | 162(98.2%) | 3(1.8%) | |
|
| ||||
| Etiology, N (%) | 0.3127 | |||
| Autoimmune hepatitis | 8 | 5(0.6%) | 3(1.1%) | |
| Cryptogenic Cirrhosis | 6 | 5(0.6%) | 1(0.4%) | |
| Alcohol | 282 | 225(27%) | 57(19.9%) | |
| HBV | 24 | 20(2.4%) | 4(1.4%) | |
| HCV | 200 | 140(16.8%) | 60(21.0%) | |
| HCV + Alcohol | 430 | 309(37.1%) | 121(42.3%) | |
| HFE | 17 | 14(1.7%) | 3(1.1%) | |
| NAFLD | 111 | 84(10.1%) | 27(9.4%) | |
| PBC | 30 | 22(2.6%) | 8(2.8%) | |
| PSC | 10 | 8(1.0%) | 2(0.7%) | |
|
| ||||
| Age, Median (IQR) | 62.0(8.0) | 62.0(9.0) | 62.0(7.0) | 0.2863 |
|
| ||||
| Gender, N (%) | 0.3239 | |||
| Female | 30 | 20(2.4%) | 10(3.5%) | |
| Male | 1088 | 812(97.6%) | 276(96.5%) | |
|
| ||||
| Race/Ethnicity, N (%) | 0.3420 | |||
| White | 727 | 540(64.9%) | 187(65.4%) | |
| Black | 171 | 125(15.0%) | 46(16.1%) | |
| Other | 58 | 48(5.8%) | 10(3.5%) | |
| Hispanic / Latino | 102 | 71(8.5%) | 31(10.8%) | |
| Unknown | 60 | 48(5.8%) | 12(4.2%) | |
|
| ||||
| BMI at referral, Median (IQR) | 29.0(6.8) | 28.9(6.6) | 29.1(7.3) | 0.4503 |
|
| ||||
| BMI at referral, N (%) | 0.7653 | |||
| Underweight (less than 18.5) | 23 | 18(2.2%) | 5(1.8%) | |
| Normal Weight (18.5 to 25) | 193 | 142(17.1%) | 51(17.8%) | |
| Overweight (25 to 30) | 436 | 333(40%) | 103(36%) | |
| Obese (more than 30) | 466 | 339(40.8%) | 127(44.4%) | |
|
| ||||
| Diabetes at referral, N (%) | 0.6576 | |||
| No | 410 | 302(36.3%) | 108(37.8%) | |
| Yes | 708 | 530(63.7%) | 178(62.2%) | |
|
| ||||
| Tobacco Use at Diagnosis of Cirrhosis, N (%) | 0.2028 | |||
| Current smoker | 480 | 352(42.3%) | 128(44.8%) | |
| Former smoker | 280 | 200(24.0%) | 80(28.0%) | |
| Never smoker | 345 | 269(32.3%) | 76(26.6%) | |
| Unknown | 13 | 11(1.3%) | 2(0.7%) | |
|
| ||||
| AUDIT-C Score at referral, N (%) | 0.0449 | |||
| Low | 983 | 722(86.8%) | 261(91.3%) | |
| High | 135 | 110(13.2%) | 25(8.7%) | |
|
| ||||
| HCV viremia at referral, N (%) | 0.3954 | |||
| No | 838 | 629(75.6%) | 209(73.1%) | |
| Yes | 280 | 203(24.4%) | 77(26.9%) | |
|
| ||||
| Cirrhosis comorbidity index at referral, N (%) | 0.6242 | |||
| 0 | 752 | 562(67.6%) | 190(66.4%) | |
| 1+0 | 241 | 179(21.5%) | 62(21.7%) | |
| 1+1 | 56 | 37(4.5%) | 19(6.6%) | |
| 3+0 | 39 | 29(3.5%) | 10(3.5%) | |
| 3+1 | 29 | 24(2.9%) | 5(1.8%) | |
| 5+1 | 1 | 1(0.1%) | - | |
|
| ||||
| CAD at referral, N (%) | 0.2183 | |||
| No | 874 | 643(77.3%) | 231(80.8%) | |
| Yes | 244 | 189(22.7%) | 55(19.2%) | |
|
| ||||
| Listed outside the VA, N (%) | 0.0250 | |||
| No | 1063 | 784(94.2%) | 279(95.5%) | |
| Yes | 55 | 48(5.8%) | 7(2.5%) | |
|
| ||||
| Transplanted out of VA, N (%) | 0.1936 | |||
| No | 1072 | 794(95.4%) | 278(97.2%) | |
| Yes | 46 | 38(4.6%) | 8(2.8%) | |
|
| ||||
| Liver cancer at referral, N (%) | 0.2809 | |||
| No | 578 | 438(52.6%) | 140(48.9%) | |
| Yes | 540 | 394(47.4%) | 146(51.1%) | |
|
| ||||
| Disease within Milan criteria at referral, N (%) (N=540) | 0.4916 | |||
| No | 46 | 35(4.2%) | 11(3.8%) | |
| Yes | 494 | 359(43.2%) | 135(47.2%) | |
|
| ||||
| Down-staging of HCC, N (%) (N=46) | 0.2760 | |||
| No | 13 | 12(1.4%) | 1(0.4%) | |
| Yes | 33 | 23(2.8%) | 1(3.5%) | |
|
| ||||
| Tumor progression while waiting, N (%) (N=524) | 0.3681 | |||
| No | 392 | 282(33.9%) | 110(38.5%) | |
| Yes | 132 | 101(12.1%) | 31(10.8%) | |
|
| ||||
| Number of tumors, N (%) (N=524) | 0.7927 | |||
| 0 | 42 | 32(3.9%) | 10(3.5%) | |
| 1 | 306 | 222(26.7%) | 84(29.4%) | |
| 2 | 119 | 86(10.3%) | 33(11.6%) | |
| 3 | 46 | 35(4.2%) | 11(3.9%) | |
| 4 | 7 | 4(0.5%) | 3(1.1%) | |
| 5 | 3 | 3(0.4%) | - | |
| 6 | 1 | 1(0.1%) | - | |
|
| ||||
| Tumor Size, (median, IQR) | 2.4(1.3) | 2.3(1.3) | 2.5(1.3) | 0.2209 |
|
| ||||
| BCLC staging at listing, N (%) (N=524) | 0.1532 | |||
| 0 | 78 | 65(7.8%) | 13(4.6%) | |
| A | 384 | 271(32.6%) | 113(39.5%) | |
| B | 60 | 46(5.5%) | 14(4.9%) | |
| C | 1 | - | 1(0.4%) | |
| D | 1 | 1(0.1%) | - | |
|
| ||||
| Distance from referring VA to transplant center in miles (median, IQR) | 317.1(389.8) | 291.9(332.7) | 426.5(582.1) | <0.0001 |
|
| ||||
| MELD at referral (median, IQR) | 12.5(9.4) | 12.6(9.7) | 12.2(8.3) | 0.1706 |
| MELD at referral, of patients without MELD exception (median, IQR) | 15.2(6.9) | 15.5(7.0) | 14.6(5.6) | 0.0393 |
|
| ||||
| MELD at evaluation (median, IQR) | 12.9(9.5) | 13.1(10.0) | 12.2(8.7) | 0.1317 |
| MELD at evaluation, of patients without MELD exception (median, IQR) | 16.0(7.5) | 16.2(7.6) | 15.4(7.4) | 0.3770 |
|
| ||||
| MELD at listing (median, IQR) | 15.0 (11.0) | 15.0 (12.0) | 15.0 (11.0) | 0.6925 |
| MELD at listing, of patients without MELD exception (median, IQR) | 21.0(10.0) | 21.0 (10.0) | 20.0 (10.5) | 0.6888 |
|
| ||||
| MELD at transplant (median, IQR) | 20.0(17.0) | 20.0(17.0) | 18.0(16.0) | 0.2161 |
| MELD at transplant, of patients without MELD exception (median, IQR) | 26.0(11.0) | 26.0 (1.00) | 25.5(13.0) | 0.8778 |
|
| ||||
| Event | ||||
| Listing, N (%) | 655 | 496(59.6%) | 159(55.6%) | 0.2337 |
| Transplant, N (%) | 334 | 259(31.1%) | 75(26.2%) | 0.1179 |
| Transplant list drop out, N (%) | 226 | 161(19.4%) | 65(22.7%) | 0.2200 |
| Pre-transplant Death, N (%) | 303 | 204(24.4%) | 99(34.6%) | 0.0009 |
| Post-transplant Death, N (%) | 32 | 28(3.4%) | 4(1.4%) | 0.0853 |
|
| ||||
| Time to Event | ||||
| Days from referral to evaluation (median, IQR) | 26.0 (11.0) | 23.0 (10.0) | 39.0 (16.0) | <0.0001 |
| Days from referral to listing (median, IQR) | 71.0 (77.0) | 69.0 (77.0) | 77.0 (82.0) | 0.1268 |
| Days from referral to transplant (median, IQR) | 244.5(271.0) | 223.0 (246.0) | 367.0 (366.0) | 0.0009 |
| Days from Referral to pre-transplant death (median, IQR) | 291.0 (361.0) | 242.0 (281.0) | 402.0 (396.0) | <0.0001 |
| Days from Referral to post-transplant death (median, IQR) | 568.5(701.5) | 521.0 (566.5) | 947.0 (213.5) | 0.0353 |